Stigma, stress, and support

I have frequently found myself in the crosshairs between the needs of a person suffering from major mental illness and the exhaustion, anxiety and frustration experienced by the loved-one caring for them.

It is difficult for clinicians to navigate this terrain, speaking to the immense difficulty of the family members themselves. I have found that most of the roadblocks in moving forward is lack of understanding of mental health issues and the immense societal stigma and ignorance that accompany them. Family members caring for the chronically mentally ill need psychotherapeutic support themselves, both because of the stress that is always a side effect of caring for the loved one, and the family dynamics that are brought to light in a patient’s treatment.

Mental health symptoms are reinforced, and sometimes caused, by early dysfunctional experiences in the family. This could be what we call “Big T” trauma (molestation, domestic violence, addiction) or “Little T” trauma (emotional neglect, coldness). So when a caregiver is in the depths of caring for a loved one with mental illness, or the identified patient (IP), these often unresolved parts of their history are brought to the light, causing stress for the caregiver themselves.

However, the response of the caregiver is often to buckle down and ignore their own emotions and focus on the IP, either because they do not want to cope with the problems in the family system that have been brushed under the carpet, or they compare themselves to the IP and come to the conclusion that their needs pale in comparison.

This is reinforced by societal stigma against mental illness and lack of understanding it engenders. This could be a whole article in and of itself — but it should be noted this greatly compounds a caregiver’s ability to address their own needs.

Hopefully, when a caregiver finds themselves involved in the mental health system caring for their IP, they will encounter a seasoned and resourceful clinician who can help steer the conversation towards a more holistic understanding of the problem and address the needs of the caregivers. However, this is likely not to happen in our current healthcare environment, where turnover and high volume often result in lack of nuanced care.

As a caregiver, you know what I’m talking about. You’re here because you know that you have to seek support yourself. Armed with this knowledge, I encourage caregivers to seek counseling themselves, either in the context of the IP’s treatment or on their own. In addition, there are many support groups specifically for family members coping with another’s mental illness, shown at the bottom of this article. It can be immensely healing to speak about these struggles with others in the same position. You can connect with other caregivers of people with mental illness here on the forums.

Psychoeducation is an immensely important component. Psychoeducation refers to the information given to the mentally ill and their family to help empower them and deal with the symptoms in the most optimal way. I have seen the power of this basic and essential tool firsthand many times. While hearing a diagnosis or prognosis can sometimes be shocking and troubling, more often than not family members and patients are relieved and experience it as a concrete way to move forward.

As a therapist, I see a main facet of my role as explaining diagnoses and helping patients and family’s process them, with an emphasis on the fact that they are “working” and highly subjective, and designed to help facilitate treatment, not define the person. For example, a patient is suffering from depression, not depressed. It’s just like how if you have cancer people say you are suffering from cancer, not that you’re cancerous.

Also essential to this is the way the problem is communicated. Mental health issues can be difficult to treat from the perspective of the clinician, patient, and family because of its abstract quality. I cannot give you a blood test to determine you have depression. However, I can affirm to patients that their symptoms are real, a disease, and not just “in their head.” Most of the time they are highly treatable with good outcomes, and this is equally important for the caregiver.

Resources for caregivers of people with mental illness

When you’re taking care of someone it can seem impossible to find time to eat, sleep, and bathe — nevermind look for love. It isn’t easy, but there are other caregivers out there who are going on dates and embarking on new relationships. Remember, everyone has their own situation. What works for one caregiver might not work for you.

Are you going on dates? Share your tips in the comments!

It’s good for you

Having a social life — and a dating life — aren’t just for fun. They’re important for your mental health. Caregiving is incredibly emotionally demanding and you need to maintain a balanced life in order to keep giving to someone else. Even an hour or two a week of social time makes you a better caregiver, because it recharges you. Plus, everyone loves bad date stories.

It’s good for the person you care for

It’s not healthy for one person — you — to be their only friend or source of support. It’s good for them to be around other people and get to socialize. Social isolation is terrible for you and the person you care for — don’t lock yourself up in solitary confinement.

It’s okay to ask for help

Needing to rely on others isn’t a sign of weakness — no caregiver should be on their own. Of course, the logistics of finding someone to provide care in your absence can be formidable. Some of us have an easier time than others — finding someone to keep an eye on my adorable autistic niece is a piece of cake, while I have to beg and cajole to get someone to keep my ornery uncle company, and neither of them requires complex medical care.

Find friends — and dates — online

Don’t know anyone you’re interested in dating? No problem. Sign up for an online dating profile, many of which are free. If you’re not comfortable joining a dating site, Meetup.com can help you meet other people to socialize and speed up the process of meeting someone the old fashioned way. Your local library will probably have a calendar of events, too.

It’s okay to cut corners

We all have only 24 hours a day — you decide how you spend it. Are all of your non-negotiable tasks really non-negotiable? Are there shortcuts you can take or corners you can cut with chores? Are you keeping busy to distract yourself from sadness? Take a look at the calendar and make a realistic decision about how often you can go out and then follow through. Don’t decide there’s no time for you in your life.

Get creative with finding help

Beyond asking for help from family and friends, there might be caregiving volunteers available through a neighborhood organization. Elder Helpers has volunteers around the country; Wake County, NC has the Center for Volunteer Caregiving; Caregiver Companion serves parts of Indiana. Please share information on other organizations in the comments below.

You can also trade time with another local caregiver. It’s also worth it to find a professional caregiver who you’re comfortable with. Even if you don’t use paid care often, having a professional caregiver who knows your loved one is priceless when there’s an emergency.

Fun can be affordable

Going on a date doesn’t have to mean dropping a bunch of cash. Many museums have free entry at specific times or free programs. Most art galleries don’t charge admission — and even have opening parties that the public can attend. If it’s nice out there are often free outdoor movies, dancing lessons, and concerts — or you can enjoy a stroll or a picnic. Ask around to find out which cafes have good specials and affordable prices.

You’ll keep the good ones

Some people will dismiss you as soon as they realize you’re a caregiver, but that might be a good thing.It’s better to realize someone’s not ready to deal with real life early on. People who stick around are going to be the type of people who will stick it out for the long-haul.

You’ll skip the bad ones

All too many of us have been guilty of going on second or third dates with people we aren’t interested in because why not? Well, when you’re paying $20/hr or have begged a friend to come over for a few hours there’s a compelling reason to not waste time with someone you’re just not that into.

Be understanding

You’ll find someone who understands that caregiving is your priority. Even if caregiving is your top priority, if you want to pursue a serious relationship with someone, they need to be one of your priorities, too. Things come up — a lot! — and that’s fine, but you need to be extra sure to let them know what’s going on. Being a no-show or vanishing for weeks on end isn’t an acceptable way to treat someone, regardless of your caregiving responsibilities.

Remember, no one thinks dating is particularly easy or fun all of the time. It’s okay to take a break from dating — or decide you’re not interested in a romantic relationship at all. But if you’re looking for love, it’s important to make that a priority in your life — and seek out the help and support you need to make it happen.

The mocha itself is at best mediocre. I get it for free from one of those institutional coffee machines you find in hospitals or convenience stores. I press one of six buttons–hot chocolate, mocha, cappuccino (regular or decaf) or coffee (regular or decaf). The machine ponders my choice. Then it grinds and sputters and spits my beverage into a 6-ounce cup.

This particular machine resides in my mother’s senior adult apartment community. When my mother moved to my city, I was glad that the transition was not as difficult as other parental moves I had heard about. My mother pared down her stuff and moved with some ease from her house of 45 years into a studio apartment. The ascetic quality of her new space suits her just fine.

More difficult was the change her move sparked for me. Overnight my schedule became tied to hers. My mother’s life became less cluttered, mine more cluttered.

That is how the mocha machine came to dispense more than just a mocha. I organize my mother’s medications every week. I also do her laundry. Once these tasks are done, she and I go downstairs to wait for her lunch hour. While we wait, I sip on a mocha.

I have never been a devoted mocha drinker, but the day the mocha machine was “out of order,” I was too. I had come to anticipate drinking that Styrofoam-flavored, somewhat chocolate flavored drink.

I sat to wait with mother the day the mocha machine was on the fritz. The stories and conversations went on around me as usual, and I found myself laughing and joining in. The weekly mocha had helped me in those initial months of transition to sit and listen and hear the wisdom-infused storytelling of my mother and her new friends. It had offered Spirit-sweetened seasoning to my caregiving activities. Now, even without the mocha, I was connected somehow.

I learned that day. I need those ritual moments that add everyday sacred seasoning to caregiving activities that can become little more than tedious and wearying tasks. The seasonings do not have to be elaborate or expensive. A mediocre mocha will do, if we treat ourselves to that mocha with the intent of enjoying a moment of holy feasting with holy people in the midst of ordinary, even mundane, life rhythms.

An altered version of this image/reflection appeared on another website. That version was not about caregiving.

Words matter

The list goes on and on about things that we don’t want to talk about — death is at the top of that list. We talk around it instead of about it. No amount of language or magical thinking will bring people back. It doesn’t give power to death to speak its name. Sugar-coating death doesn’t make it easier, but it can make it harder.

We are late on a project. Our house needs work. If, God forbid, we have a serious health problem or lose our job, it can consume us.

Focusing on our problems, we sometimes overlook our blessings. As a father, I know I do this. I complain that my kids do not go to sleep on time much more than I express gratitude for being blessed with healthy, happy kids.

Sometimes we need a little push to remind us of our blessings.

That is the lesson of a beautiful Yiddish story about a man who lived in a one-room hut with his mother, his wife, and six children. The hut, as we can imagine, was filled with crying and quarreling. It was noisy and hard to live. One day, when he felt he couldn’t take it any more, the man went to his rabbi.

“Rabbi,” he said, “things are bad and getting worse. I live in a one-room house with my mother, wife and six children. It is too crowded and noisy. Help me find some peace, Rabbi, I’ll do whatever you say.”

A Chicken

The rabbi thought for a moment. “Do you have a chicken? he asked.” “Yes, of course I do,” the man replied. “Good,” said the Rabbi, “take the chicken and bring it into your home.” “Well, okay,” said the man, though he was a bit surprised.

Imagine what the house sounded like now. In addition to the man, his mother, his wife and six children, there was a chicken clucking incessantly. Frustrated, the man returned to the Rabbi. “Rabbi, I did what you said, and it’s much worse than before. Help me please.”

A Goat

“Tell me,” the rabbi asked, “do have a goat?” “Yes, I do,” the man replied. “Excellent,” said the rabbi. “Go home and bring him in to live with you.” A couple of days later, life in the hut was even worse. There was crying, quarreling, clucking, and a goat pushing and butting everyone with its horns.

The man returned to the rabbi. To his shock, the rabbi then instructed him to bring his cow into the hut. This Rabbi must be crazy, the man thought. But he did as he was instructed. The house became an utter chaos.

The End of the World

When he returned to the rabbi for the fourth time, the man screamed, “Help me rabbi, the end of the world has come. There is no room in my house even to breathe.” The rabbi listened and said, “Go home now, my friend, and let the animals out of your hut.” The man rushed home and did so.

That night was the sweetest and most relaxing night he ever had. Every member of the family slept comfortably and peacefully. When he returned to the rabbi, the man said “Rabbi, you have made life sweet for me. With just my family in the hut, it’s so quiet, so roomy, so peaceful…What a blessing.”

What a blessing. When we feel overwhelmed, we can gain perspective by counting the blessings we enjoy each and every day.

And we’re here to support you

I love to travel and am known for my inability to stay in one place for very long, but sometimes I decide I need to be at home to help.

How can I stay at home without feeling trapped?

I remember why I’m staying at home. I’m here because someone I love needs my support and I want to be there for them. There are plenty of times when I wish I could be somewhere else, but it’s important to me that I’m a good spouse and a good granddaughter, so here I am at home.

I find ways to experience the world without really going anywhere. What do I mean by that? I’ve always been excellent at keeping myself entertained (oh boy does my mom have stories!). There are lots of ways to invite the world in to where I am at home.

Watch a documentary

Netflix, Amazon Prime, and ye olde TV have an endless supply of documentaries to choose from. Believe me, it’s easy to learn more from a documentary than you would learn from spending a week in a place. Pick one out and let it take you on an adventure. And then, if you’re like me, you’ll end up with a whole collection of things to research.

I also go through phases where I watch foreign movies. Back in the dark ages before streaming movies, my dad used to buy German DVDs in bulk off of eBay and take a chance on what he got. Let’s just say that he very quickly realized that was a bad strategy. As a consequence, I’ve seen a lot of weird foreign films.

Read a book

Documentaries are fun, but sometimes it’s nice to put your brain to work. I used to go to my local library often enough that the guy who worked in the mornings was consistently the only person who ever noticed when I got a haircut. Nowadays I don’t make it over as often because the NYPL has an app that allows me to download digital books to my phone (and my wife’s Kindle). Amazon Prime lets you download books, too. If you’re afraid that staring at the screen so much is going to make you blind, it’s time to pull those classics off the shelf and give them another go.

Go to a museum

Most museums and art galleries are pretty good about accessibility. Check out the museums in your area – usually someone will be (reasonably) happy to tell you if they have accessible bathrooms, ample seating, and an off-peak time so you can skip the crowds. Many museums also have discounts for seniors and students. You can even ask your local library or friends if they have a museum pass they’ll let you borrow.

Write about your travels

I’m not really sure if this fans or cools my wanderlust, but I’ve taken advantage of my time at home to write up my travel adventures or curate my photo collection.

Master a new type of cooking

Learning to cook a country’s national dishes teaches you a lot about a culture. As Tembi reminds us, it also brings us closer to the ones we love. And it’s delicious. When I was in high school I’d have to track down specialty grocery stores and “ethnic” stores to find ingredients that are now on the shelves of my neighborhood store. Pick an ingredient you can’t identify and figure out how to use it. Trust me, it’ll be fun. Just keep food safety in mind.

Host a visitor

I’m obsessed with CouchSurfing. Okay, I know this sounds insane. Who would want to stay with someone who’s ill and what ill person wants visitors? Travelers are people who have disabled and ill relatives, just like you, and they know it’s not a big deal. Everyone likes having someone new – who hasn’t heard grandma’s stories 600 times already.

Be a kid

Want to go camping? Set up your tent indoors. Rearrange the living room into a craft zone jungle. Keep an eye on the trash for giant cardboard boxes that could be pirate ships, forts, or time machines. Live it up. No age is too old to have fun.

Live vicariously

My adventures have introduced me to a lot of amazing people from around the world. Tomi, Sabina, and Jeff all give me ample opportunities to explore vicariously (and want to eat all the time). I love following along at home. I also enjoy the postcards that appear in my mailbox at random intervals, sometimes from people I haven’t heard from in years.

And if you really can’t bear to stay home anymore, a friend of mine is starting a travel agency for special needs kids, so stay tuned for that.

I don’t always think of the other person. None of us do. We get so caught up in our own thoughts and feelings that we lose sight of the other persons’ feelings. I was feeling frustrated a few years ago as I tried to take care of all the errands, the pharmacy runs, grocery shopping, keeping vehicles running, and trying to hold onto enough work to pay the bills. Upon finishing one task, I would often find two more immediate needs that had to be taken care of to take the place of the one I had just finished. It was very frustrating. We were dealing with those ulcers that form from pressure sores and my wife was not a happy camper! She had to stay in bed and only lay in certain positions. There is only so much a person can do with a restriction like that.

I tried to provide as much entertainment as possible, but it was rapidly getting her frustrated, too. I made sure she had her computer, plenty of videos and snacks as well as liquids, knowing that it would all be rather inadequate by the end of the day to relieve her boredom. Off to work I would go, all the while worrying about her, wondering if she was alright and generally a bear to live with myself as the stress and frustration continued to build.

It is easy to get into arguments. And it is just as easy to have them drag out for a long time. It really boils down to how we choose to react to each situation that comes up. I would often hear the negatives that were spoken much more clearly that I would hear positives if I chose to do so. And by the same token, if I chose to listen for positive feedback I would notice and hear a lot more positive comments. The direction and type of conversation is always determined by how we react or respond to what is spoken to us.

On one particularly trying day, I was out repairing a cooler fan for a friend and earning some money doing it. He observed that I seemed to be a lot more stressed than I had been in church the previous Sunday. I gave him a rather lengthy description of all the things I was dealing with that week and how I was getting very frustrated with it all.

He broke into my long description of things to remark that he felt sorry for my wife. I paused and let that sink in a moment and then asked him what he meant by that statement. He answered that if she was having to lay in one position for a long period of time, she probably was as frustrated as I was. Because my friend was a public school administrator, he was well aware of my wife’s teaching career. He pointed out as carefully as he could, (I think he might have thought I was going to react the wrong way) that my wife was used to being up and active and dealing with a classroom of students. He pointed out that she was probably going stir crazy by that time in the afternoon that we were working on his cooler. He then said something I have often heard and just as often lost sight of, which is before you get too hard in judging people, walk a while in their shoes. If someone else had said that I would have thought they did not have a clue what it was like to be a caregiver. But that was not true of my friend. His wife had Alzheimer’s and she was starting to lose ground rather rapidly. He definitely had been in some difficult situations with her mental health deteriorating as it was.

This conversation reinforced something I would often counsel the families of drug addicts to do. I was involved in working with drug addicts and alcoholics to help them get their lives on track and off the addictive chemicals. One principle I would teach the guys I was mentoring was to respond to situations, not react. When we react we tend to blurt out whatever comes to mind first and it is usually the wrong thing to say. But if we respond to what is happening, it means we are tailoring our words and actions to bring resolution. Anger, frustration, hurt feelings, emotional retaliation come out of those reactions that are not thought through carefully. A response is generally going to ease the tension or lighten the mood while a reaction in kind is going to escalate the friction and hurts.

Some principles are obviously good for any married couple or family relation. But when in a caregiver/patient relationship, the failure to understand the other person is going to greatly aggravate the discussions and conversations.

My friend the Police Officer who lost wife, mother and father over a few years to cancer once advised me to consider that the pain and frustration coupled with the inability to move or function normally will be especially difficult for the invalid. He said that as a Police officer, he had been called for domestic disputes. He would be accompanied by a social worker and would go on calls where family members were in loud or even violent arguments. The purpose of the calls of course, was to resolve the conflict before the people did each real harm. He observed that when people were normally active and busy and they found themselves immobilized by an accident or illness, the situation was especially hard for them to endure. Conversely, if a person was a couch potato before they were laid up, there wasn’t as much frustration on the part of the invalid.

Over the last few years, I have been involved in several counseling situations involving a caregiver/patient situation. All of what my two friends pointed out has proven to be true.

My Police officer friend also pointed out several other things that we often don’t realize. That is, we are dealing with someone that is soon losing track of time as we know it. The patient can ask for a bowl of soup and you the caregiver might be moving double quick in getting it ready, but to them you are dragging your feet. This is because a watched clock tells time slower, and a watched pot never boils. I know those are old cliche’s, but the fact is, time drags forever for the invalid confined to the bed, while the caregiver is struggling to fit all the tasks needing to be done into the day. And if you are a working caregiver, and are trying to make a living while caring for an invalid at home you are actually pulling a double header every day.

I often say a prayer of thanksgiving when I think about my wife. She is an artist, she reads, she can do a lot from her bed or wheelchair. Not only that, but she tries to see my side of a situation. I found that communication is key to keep the resentment from building. If you are caring for someone who is coherent and lucid, there is no reason why they should not understand that your world cannot revolve around them 100% of the time. However, for those who refuse to see your side, there is really not much you can do about it. It goes back to reacting or responding again. What you do with that reality will be what determines your thought for the day, your dominant feeling and your general outlook on life.

There are many issues that are manifesting in the care of an invalid. But one thing we often don’t recognize is the fear the patient is feeling. Surprised? Don’t be! It is a very real issue for the patient receiving care.

Twenty-five years ago, I had a chemical accident on a job I was doing. For a period of time I was hospitalized and on life support. As I got well enough to communicate with the doctors and nurses in the hospital, I asked that my family would be contacted. When the nurse placed the call to my wife, she made it clear she was not interested in carrying on the marriage if I was so sick. Her last words to me were, “I did not marry you to watch you die. You will never see me or your children again.” The doctors next contacted my parents, and my dad said I would be fine, that all I needed was time to heal, but he did not want to take the time to come and visit or offer even to talk on the phone. That changed my perspective on things dramatically, I can assure you! But the fact is, whether we like to think about it or not, whether we like it or not, we fear being left alone. So again, walk a while in their shoes. The person you are caring for may be an older family member. But when you look around, the only person you see is the one looking back at you in the mirror. There may be aunts, uncles, cousins, brothers, sisters and other relatives close by. But you see very little help. Our reaction? We dwell on the fact and think about the fact that we are the responsible one, the lone caregiver and provider of services to the patient. We only see and think of what we are feeling.

What do you think mom or aunt or dad or uncle or grandparent feels? They too see only you. They too are aware of the number of people in the family. It might not come to mind for them right away, but sooner or later, the thought will occur to them that you might abandon them. That thought will grow into an oversized fear very quickly if you start getting short tempered. Then the real friction starts. As you get short tempered or frustrated, the patient gets more fearful. Responses are replaced with reactions. Tempers flare, Feelings get hurt, and things are said that cannot be erased from the other person’s memory. Trust begins to erode. You can easily find yourself locked in an uneasy truce that is only peaceful because you are both to fearful or tired to fight.

Looking at the memories again, I said before that the chemical poisoning accident I had was twenty-five years ago. But one of the things that happened was that I had a very difficult time trusting caregivers, therapists, doctors and medical personnel. I still do have trust issues. Things that happen like a family member rejecting you or walking out on you will cut deep and leave a bruise on the soul that can take years to heal. When it came to family, my reaction was that if my own wife didn’t want me, why would anyone else? I stayed with friends for several years. At first, I needed a lot of TLC. My body had been badly damaged. The chemical that I was exposed to had a deadly effect on nerves. I went for eleven years before I could feel my fingertips again. Because the chemical was a solvent based product, something as routine and simple as pumping gasoline into my vehicle could trigger a reaction so severe that I would find myself waking up in a hospital again.

Fear is a real issue in the patient’s mind. The patient knows that you are walking and mobile. They know they are taking your time. They know you are not out there living life like you would if they were not in your care. So the other enemy in their mind is an often overwhelming feeling of guilt. There is really nothing you can do about that. The fact is, it will be there. Both of those enemies to your relationship will be there. Fear and guilt.

On your part, the enemy is going to be the frustration and resentment. At least with some. Honestly, when I cared for my wife at first, I was proving to myself that I was not selfish like I saw my ex-wife as. That kind of crusade loses it’s appeal and warm fuzzy feeling fast. But my wife became my wife because I fell in love with her. Because I loved her I married her. I challenged myself to express my love for her in everything we did together. I would look for ways to do things so that she would see that I was a willing participant in her life rather than a reluctant resentful partner. It is harder to live that way when bills are piling up, vehicles are barely hanging together, medical supplies are eating every spare penny and it is hard to set a schedule because of ever recurring health issues. But we do schedule date nights. Something that can be as simple as reading together, watching a DVD together or playing around with artwork. The point is to do things that are family and friendship building rather than just the constant caregiver/patient interactions.

I was talking to a friend just a few hours ago before starting this article, and I told him that at the point that I go to the mailbox and the medical bills with the dozens of fees, copays and charges total in the hundreds of thousands, that a person has to realize that the important thing is not what is happening, but how we are going through it. I don’t mean that in a fatalistic way, although it is not a very long step down into frustration, fatalism, despair, and depression. But what I mean is that you will not pay a bill or charge at the ER any faster by allowing it to overwhelm your mind with worry. But we can make our life, our living, our day to day existence infinitely brighter and more joyful just by concentrating on the truly important things that are eternal. I noticed that my wife can handle a huge amount of stress, fear, and doubt when she knows she is cherished, loved, and wanted. But if I am distant, short tempered, or noncommittal, she gets agitated far quicker when dealing with doctors, nurses, and medical staff. Whatever feeling we are allowing to dominate us is going to eventually affect our relationship with the patient.

I noticed that my wife can handle a huge amount of stress, fear, and doubt when she knows she is cherished, loved, and wanted. But if I am distant, short tempered, or noncommittal, she gets agitated far quicker when dealing with doctors, nurses, and medical staff.

One thing that made a huge difference for us was acquiring a dog. This is not for everyone of course, but for those who are able, a pet is often a stabilizer in the home. The attached picture is not a photo of Benji, but of another dog acquired earlier. We have a Schnauzer that is almost blind but very well trained. Benji, (I know! We didn’t think too hard to name him that!) has been a great source of comfort for my wife and has provided hours of entertainment for all of the family. Getting a pet is often a good thing, but having a pet that greatly increases your workload is not a good thing at all. So choose wisely. I know of several families in our area that have a lapdog or cat in the household to give the patient comfort and companionship. One lady I built a ramp for and remodeled the bathroom in her home is a cat lover. She has two cats that are absolutely convinced that they are the owners and she is the pet. But the fact is, they are able to get close and snuggle and she feels and has comfort from that. In spite of the fact that many family members live nearby, she seldom sees them and the only person she does see on a regular basis is a nurse caregiver from an In-home Patient Care agency. Her cats have taken on the personalities and there is a very real bond and comfort in that situation. The huge benefit for her is that because the two cats are litter box trained, they are extremely low maintenance. The only real cost is a sack of dry cat food once a month in the grocery shopping.

The death of any relationship is when the practical demands and needs completely replace the tender, familial, friendship based, love based feelings and attention. One of the contributors to the breakdown of the relationship occurs when all the patients’ acquaintances are reduced to medical staff and you, the primary caregiver.

I cared for a Korean War vet over thirty years ago and our relationship was made much easier because he had friends and former co-workers who would come and play checkers and Backgammon with him which would give me some time to rest and take care of me. I didn’t always leave, because I liked those old men who came over every few days. They would joke and kid around and swap stories and tall tales about fish they caught or elk or deer hunts and sometimes they would talk about their part in wars. They were not always talking of happy things, for memories of fighting in the Korean war were not pretty, but they were closer as friends than most families I have seen. The bond and support they gave to each other was more valuable than words can describe.

Again, if the patient you are caring for, sees only you and the medical staff, the patient may get rather reclusive, withdrawn or belligerent. Since you are the only one there, you will bear the brunt of all those bitter feelings they harbor in their heart.

But regardless of the situation you are in, if you do not get some time for yourself to recover and restore from time to time, you will burn out. It is essential that you take care of yourself so that you are able to care for your patient.

I am going to add this last point as a pastor as well as a caregiver. The people who are able to fellowship in a church or synagogue every week weather the storms of caregiving much better than those who do not have a place to go and just sit and soak in some brain and heart food. It is never good to be continuously alone and isolated.

One year ago my father passed away. It was a several year battle against cancer that he eventually lost, and I still miss him deeply.

My mother has struggled in the aftermath. She has been overwhelmed with loneliness and sank into a depression. She loved my father deeply and he was her rock, both emotionally and in a more practical sense (bills, caretaking, house upkeep).

Lately she has struggled more deeply because a chronic pain issue flared up. She has been to numerous doctor appointments, tried multiple medications and treatments, with no improvements. The medications make her groggy and confused, and she has been having trouble sleeping on top of everything. It seems like her life is a waking nightmare.

I love my mom very much, but I am struggling with how to help her. I am an only child, and we have few extended family members – none she feels she can rely on. She has friendships, but does not trust her friends easily/well and has withdrawn lately because she is too exhausted to reach out. She usually rejects the idea of outside/paid help and feels very vulnerable.

My relationship with her has always had some tension. She is a wonderful mom and a caring person, but our personalities have always clashed. She has always needed more from me than I felt capable of giving, but that need has grown immense and my ability to help her has, if anything, decreased. My own life has been challenging – a stressful new job, a wonderful-but-complicated marriage, and grieving for my father.

I try to visit as often as I feel can, have offered help in various forms, but visits are filled with her lamenting that she doesn’t have anyone to help, and my offers of help are turned down more often than not because they aren’t the right ‘kind’ of help (she has rigid parameters and a deep need for control). Her control issues are also triggering for me, because control issues are something that I struggle with as well.

I have always found visits with my mom draining, and even more so now in this acute time. Every interaction with my mother has the ability to send me into my own tailspin, but setting boundaries makes me feel incredibly guilty in the face of her deep need – and the fact that she is a good person and mother.

How can I navigate this tricky balance? How can I help my mom without losing myself in her bottomless pit of need? How can I maintain my own mental health without feeling like the worst daughter ever?

Nicola Brown is passionate about travel, food, digital media, and psychology. An award-winning writer and communication consultant, she is owner and principal of Think Forward Communication and Editor-in-chief at AnewTraveller.com

Religion is an important source of strength for many of our members, so we’re asking clergy from different religious traditions to share how their members mark the end of a life. Today we’re speaking to Ade Justus of Righteousness of God Ministries, an Apostolic Christian church.

What does your faith teach about happens to people when their lives end?

My faith is based on the bible and here’s what the bible teaches about people when their life ends. Bible says after death is judgment. We believe there is life after death, so when a man dies, he is going to face the judgment of God based on how he spent his life. If he died in righteousness there is hope of eternity, but if otherwise he will face eternal condemnation.

How do clergy comfort the dying? How do lay people comfort the dying?

Clergy comforts the dying, based on the knowledge, believe and faith of the individual. Jesus said that whoever believes in Him will have eternal life. So the best way to comfort the dying is to let them know that, they will be welcomed into eternal bliss by the virtue of what Jesus has accomplished for them on the cross, and by personal experience with Jesus.

The bible provides a way for lay people to comfort the dying. They can come in agreement in prayer with the person and follow what the bible says in James 5:13-16.That is the best way to comfort them.

How do members of the community traditionally respond to the death of one of their members?

The response of one community defer from another, it depends on the community you belong to. It is a mixture of different faith, so all have different ways to respond to death. But there is no better way to respond than to console one other and show each other the love of Christ.

Is there a service to memorialize the dead? What is it like?

There is no service to memorialize the dead in the New Testament. But some churches hold such services.

What rituals of mourning are there in your faith?

There are no rituals of mourning in my faith based on the New Testament.

Is there a particular amount of time allocated for grieving?

There is no time allocated for grieving, it’s all about the grace to let go of what has happened and understand what bible said about the dead, that we shall still meet again in heaven. So we can grieve for a while and then rejoice because we know we’ll meet them again and also thank God for a life well lived.

What text or passage would you suggest to a member of your faith community who is grieving?

The text for those that grieving are 1Thessalonians 4:13-18, 1 Corinthians 15:51-52.

What words would you share to comfort members of our community who may be mourning?

The word to comfort member of the community mourning is to let them know the bible regards death as sleeping, and that we have hope of seeing those that are dead again in eternity, 1Thessalonalns 4:13-18.

Is there a tradition from your faith that might be comforting for people of other faiths?

We have no tradition but salvation. Believing in the finished work of Jesus Christ is comfort enough for the people of our faith.

Tired of dealing with bodies? Explore the world instead. It’s amazing to realize just how big the world is – and it makes the news a lot more interesting when you recognize all of those places they’re talking about.

For the indie rocker

For the historian

For the architect

For the hip hop fan

For your mom

Religion is an important source of strength for many of our members, so we’re asking clergy from different religious traditions to share how their members mark the end of a life. The Reverend Dr. Leanna Fuller is assistant professor of pastoral care at Pittsburgh Theological Seminary and is a member of the United Church of Christ, a mainline Protestant denomination.

What does Christianity teach about what happens to people when their lives end?

First, it’s important to recognize that Christianity is a very broad tradition that includes quite a bit of variation in belief and practice around particular topics such as death and dying. However, I think it’s fair to say that Christians typically affirm that when we die, we enter fully into God’s presence, and that we are held eternally in God’s love and care. Often people talk about this in terms of “heaven,” though individual Christians or streams of the tradition may differ on what exactly heaven will be like. Still, most all Christians would agree that when our earthly bodies die, we go to be with God.

How do clergy comfort the dying? How do lay people comfort the dying?

Within the Protestant tradition, the ways that clergy and lay people comfort the dying are, for the most part, quite similar, as we believe pastoral care is work to which all the people of God are called (not only the ordained). Both clergy and lay people might comfort the dying by sharing passages of Scripture with them, praying with and for them and their families, offering practical assistance (such as cooking meals) to families who are caring for dying persons, and simply assuring the dying person that he or she is held by the love of God and that God is present with him or her at every step of the dying process.

How do members of the community traditionally respond to the death of one of their members?

Many Christian communities respond to the death of their members by having a time of visitation with the family very soon after the death (either at the funeral home, at the church, or at the family’s residence); a funeral or memorial service within the days or weeks following the death; and then follow-up care farther into the future, including calling or sending cards to the bereaved family members, visiting the bereaved and offering food or other practical assistance to them, and occasionally having formal times of remembrance for members who have died within the context of the community’s regular worship services.

Is there a service to memorialize the dead? What is it like?

Christian communities vary in the particular ways in which they memorialize the dead, but most have some type of funeral or memorial service that they offer in the days or weeks following someone’s passing. Depending on the community’s particular tradition, these services will include some or all of the following: Scripture readings, prayers, music, a short homily (sermon), one or more eulogies (remembrances of the deceased shared either by the presiding minister and/or by the deceased’s loved ones), and rituals surrounding the committal of the body or ashes.

What rituals of mourning are there in your faith?

The primary ritual of mourning in most Christian communities is the funeral or memorial service. Beyond that, other rituals of mourning might include a time each year when all members of the congregation who have died in the previous 12 months are remembered in a special way during worship (many congregations do this at All Saints’ Day), or in some traditions it is customary for bereaved family members to wear particular kinds of clothing (only black and white, for example) for a set period of time after their loved one’s death.

Is there a particular amount of time allocated for grieving?

The tradition itself doesn’t set a particular amount of time for grieving. Unfortunately, the broader culture in the United States seems to be quite impatient with the grieving process and expects people to be “done” with it in a very short time (for instance, most employers only offer 3 days for bereavement leave, no matter what type of loss it is.) So, many Christian communities may have inadvertently absorbed this attitude and may feel anxious for bereaved members in their midst to stop grieving and “move on,” when, in fact, most contemporary research on grief suggests that grief never really ends. Instead, it usually changes in intensity over time, but the person who has suffered the loss will probably never be quite the same again, and will have to learn how to create a “new normal” for him- or herself.

What text or passage would you suggest to a member of your faith community who is grieving?

What words would you share to comfort members of our community who may be mourning?

As a pastoral caregiver, I am aware that no words, no matter how eloquent or powerful, can take away another’s pain. However, I do think that assuring people of God’s presence with and love for them can be extremely comforting in times of grief. I also try to find ways to share my commitment to be present with the bereaved – to assure them that I will be there for them if they need someone to listen or to sit with them in their pain. As I often tell my students, “Most people won’t remember what you said to them; but they’ll remember that you were there.”

Is there a tradition from your faith that might be comforting for people of other faiths?

I can’t really think of anything specific – other than having the community of the faithful gather around the bereaved and hold them up with love, prayers, and other signs of support. I imagine that most people of other faiths already do this in some way, but I’m reminded that very often, bereaved people have told me that it was the love and support of their faith communities that helped them to get through the most intense moments of their grief.

The Rev. Dr. Leanna Fuller is a graduate of Vanderbilt University (Ph.D.), Vanderbilt Divinity School (M.Div.), and Furman University (B.A.). Her dissertation is titled “When Christ’s Body is Broken: Anxiety, Identity, and Conflict in Congregations.” Fuller has earned numerous fellowships, awards, and honors. She received the Louisville Institute Dissertation Fellowship in 2010-2011 and multiple graduate teaching fellowships from Vanderbilt. Fuller’s most recent conference paper, “Anxiety, Emotions, and Encounters with Difference” was presented at the Academy of Religious Leadership Annual Meeting. Her ministry experience includes serving as associate pastor of Oakland Christian Church in Suffolk, Va., where she coordinated youth ministry and Christian education programming. Fuller also worked as chaplain resident at Riverside Regional Medical Center, in Newport News, Va., providing pastoral care for patients. Fuller’s family includes her spouse, the Rev. Scott Fuller, a UCC minister and chaplain; and their 3-year-old son, Simon.

You are there listening to the doctor tell you and your loved one that they have a fixed amount of time to live. If you are lucky they can stretch it out somewhat with medication, therapy, hospice care or a few other options. Going home the mind plays the scene over and over. Going through the daily tasks the futility of the whole list of chores continues to rear up and mock you. You might not realize it at the time of the death sentence pronounced by the doctor, but you have already begun to mourn the loss of the person you care for. Whether a paid care provider or a family caregiver, you are anticipating the loss and death of the person. It colors everything that you do from that point on. It lurks in the back of the mind and sometimes at the most inconvenient moment, the tears come. Not that there is a convenient time to break down. There is always something that needs to be addressed immediately, if not sooner. But there it is.

I have found myself in that place a few times. Then as if by a God sent miracle my lover is given a new grip and an extension on life. The first time that it happened was definitely the toughest time. It was hard to comprehend that a seemingly minor infection could threaten kidneys and internal organs so quickly and threaten brain damage due to high fevers. The feeling of helplessness is always along for the ride. So too, the depression and anxiety that stems from worrying about whether you are dressing the wounds properly, the fear of introducing another infection or bacteria into an open wound, and the constant waking to check and make sure that you hear that slow gentle rhythmic breathing that indicates everything is still okay during the sleep time.

This is a feeling and condition that you cannot explain or properly describe to friends, other family members, or church members. It is a place that feels so lonely that even though you are surrounded by doctors, nurses, possibly church members and pastor’s staff, you feel completely alone and solitary. You wonder if anyone understands. If anyone wants to understand.

So what do you do? How do you handle the stress, the fear of loss, the doubts and the anxiety? How do you handle the feeling of isolation and loneliness? The fact is, most people don’t handle it very well if at all. The largest obstacle, the biggest enemy is the chronic or clinical depression that settles in your heart, mind and soul, that overwhelming sense of defeat and futility that so envelopes your mind and feelings that you are on auto-pilot. Not really thinking anymore but just going through the motions. This is a very dangerous place to be. Depression shuts down our ability to see things clearly and rationally. This is where mistakes can be fatal. And if not fatal, they can be costly in time lost and financial costs too.

I have been a caregiver to more than one person in my working life. Early in the time I lived in Albuquerque, NM I took a year off from all work and efforts in ministry and cared for one of my closest friends. Ervin had melanoma Carcinoma. He had tumors forming in his body so quickly that the medical staff treating him could not keep up. One tumor on his shoulder ballooned so rapidly that it looked like a second head sprouting from his shoulder next to his head. Two others formed in his brain cavity and pushed his skull into a different shape as they grew. Still others formed in and on other parts of his body. He was given massive doses of pain killers to keep him from suffering. He refused to take them. He would only take enough to deaden the worse of the pain.

Ervin had been a member of a church I had pastored the previous year. For the entire nearly four years I was in that pulpit Ervin would come and sit in church and during the week he would invite me to come to his restaurant in a neighboring town to eat on his tab. He often said while he was slowly dying before my eyes, that he wanted me to get the mourning out of the way so we could talk of the really important stuff. We often sat into the night talking of science, theology, creationism versus evolution, construction practices, politics and a wide range of other topics. We both read extensively and we both saw that we could always learn more. We would be in the middle of a conversation and he would interrupt with a reminder that he didn’t have long to live, so get to the point of the conversation. He said he wanted us to say our last words about him when he was alive, because when he was dead he wouldn’t be there to hear what we had to say. He thought it important to make sure that peace was made with everyone before he left us.

He asked me to watch over his wife and family during his final days. It was assumed he would be out of his mind with pain by the time he passed, but he was not. He was alert and coherent right up to the moment when he stopped breathing in my arms as I transferred him from the bed to his wheelchair. One moment he was talking about the drudgery of going to doctors and the next moment he took a deep breath and died. This was a new experience for me, to be there at the very end holding a friend when he slipped into eternity. But it was the most peaceful of all the times I have dealt with funerals. I arranged for his funeral on behalf of his family. We held it in the First Baptist Church in downtown Albuquerque. I expected some friction from family members because not all of them got along so well, but the funeral went very smoothly, and afterward, even family members who did not get along with one another were at peace.

This was a huge contrast with other caregiving situations where no one acknowledged the impending death of the invalid. I saw not only the danger of depression at that point but of denial too. Denial is so much more difficult to overcome. By it’s very nature, denial is a refusal to see or accept reality. Mourning is so much more difficult and deeper and has a much greater negative effect on the family. I have heard quite a few people over the years lay claim to a miracle. I have heard people espouse the virtues of positive thinking. I have heard people cling to statements by doctors that there might be a breakthrough and new medicine to combat the issue. I have also noticed that the people who hold on to unrealistic expectations when confronted with reality are deeply disappointed and very defeated and depressed after the invalid passes.

For the people who are in Bible-based, Baptist, or Word-based churches, death is not a terrible end to a life. It is a transition, a stepping through the veil to a new life and body that will never grow old or hurt. Of the last four funerals I have attended that were honoring church members who were friends, the theme has been one of celebration for the departed, that they have received their reward. They are no longer suffering, their pain is over, their race is run and they have inherited the crown of life. We do not mourn as others do who have no hope, and even though we miss the physical presence of the departed we know that one day we will meet again and be forever joyful. When we mourn, we mourn that we could not have done more, could not have shared more and we are reminded that we are all going to pass and so we try to live a life that will convince people around us of the hope we have.

When we mourn, we mourn that we could not have done more, could not have shared more and we are reminded that we are all going to pass and so we try to live a life that will convince people around us of the hope we have.

Our funerals are celebrations of the life lived by a friend or family member. We share the good times we had together, the challenges overcome, and the obstacles removed from our paths.

My mother passed away in 2008. Her heart had been under a strain for at least a year. She had lived through some terrible accidents in the past, and she was ready to go home. One night she asked me while being cared for at my brother’s house if I thought it would be okay if she could go home to Heaven. I told her it was okay and to answer Him when He came for her with a yes. When she passed on, my sister in law Kathy, told me that she asked her the same thing and then just said okay when Kathy told her to go ahead. She was assured that her children were well and would not be abandoned (A mother to her children to the very end) and Kathy said she just went home.

Religion does not give that perfect peace. There are many religions in the world that demand that the subjects die for their god. But many doctors I have talked with assure me that the great majority of people who go to their final rest peacefully sometimes gladly and eagerly are people who have a relationship with God. That I think is the greatest help in the passing of a loved one who has required caregiving. There is a knowing that there is a rest, a place of peace waiting. Mourning is greatly magnified by fear of the unknown and the sense of total loss. But as an ordained pastor/evangelist, I can assure my listeners, that we are not hopeless, we are not helpless, we are not alone, we are not going to destruction, but we are entering perfect peace. Those who do not have this hope in themselves wrestle with huge and overwhelming fears of the unknown and the finality of it all. One particular doctor who had witnessed numerous deaths in the hospital that he worked often said that the patient would suddenly express awareness of Heaven or of angels and some would say the name of Jesus with such peace and joy that he would be greatly affected by the emotion.

So for us who are with one another in fellowship, in worship of God, in the Bible based Christian fellowships, Death is a graduation. Mourning is not the same for us. It is an experience that is part of living. Just a step into the next life and for those of us who are alive and remain we have a great anticipation to join them who have passed one day.

Anxiety disorder is a common mental illness that affects many people worldwide. Seeking help is important in order to encourage and maintain a healthy life. You can do this by building important relationships, visiting a psychologist, and being gentle with yourself. One of the best techniques of dealing with anxiety is to relax and breathe, reminding yourself that everything is going to be okay. Believe it or not, well known people suffer from anxiety, such as the singer Adele and the actress Whoopi Goldberg. Remember that you or anyone you may know who suffers from anxiety can get through this.

Religion is an important source of strength for many of our members, so we’re asking clergy from different religious traditions to share how their members mark the end of a life. Angelo Volandes, M.D., practices internal medicine at Massachusetts General Hospital in Boston, and is on faculty at Harvard Medical School. He is an advocate for patients and families and the author of The Conversation: A Revolutionary Plan for End-of-Life Care, about how people can empower themselves to get the right medical care at the right time and on their terms.

What does your faith teach about happens to people when their lives end?

In the Greek Orthodox Tradition, Greek words used in the Bible often influence our understanding of belief. For example, the word “asleep” is from the New Testament word koimaomai, which gives us the word cemetery. As a young person in the church, I often understood death to be a person sleeping: metaphorically they are no longer in their bodies but that does not mean they don’t exist. Rather, they exist in another world, no longer struggling with the cares and issues of this world

How do clergy comfort the dying? How do lay people comfort the dying?

I think one of the most powerful acts that clergy and lay people offer to the dying is to read prayers and hymns. This simple act reminds people that this earthly existence is temporary and that mortality is a fact of our existence.

How do members of the community traditionally respond to the death of one of their members?

The memorial service is participatory. The entire community chants in response to the hymns chanted by the priest. I think this is a powerful means by which the community comforts the family and celebrates the memory of the departed.

Is there a service to memorialize the dead? What is it like?

The Greek Orthodox service for the dead includes prayers for the departed, as well as prayers to comfort the living. Many of the themes of these hymns refer to our own limits and mortality in this world. All the prayers and hymns are chanted with Byzantine music, which is simultaneously mournful and consoling.

What rituals of mourning are there in your faith?

The memorial service is performed on the day of death, as well as the third day after, the ninth day, the fortieth day, three months, six months, and the first anniversary. This cycle of mourning allows the community to both celebrate and remember the departed.

Is there a particular amount of time allocated for grieving?

Grieving is allowed for about a year.

What text or passage would you suggest to a member of your faith community who is grieving?

I am an image of Your ineffable glory, though I bear the scars of my transgressions. On Your creation, Master, take pity and cleanse me by Your compassion. Grant me the homeland for which I long and once again make me a citizen of Paradise. Blessed are You, O Lord, teach me Your statutes. Give rest, O God, to Your servant, and place him (her) in Paradise where the choirs of the Saints and the righteous will shine as the stars of heaven. To Your departed servant give rest, O Lord, and forgive all his (her) offenses.

What words would you share to comfort members of our community who may be mourning?

I think the process of mourning takes times. The beauty of the memorial service in Easter Orthodoxy is that it occurs over the course of a one year cycle, allowing the family to mourn the loss while recognizing that the departed exists in a place apart from our earthly toils.

Is there a tradition from your faith that might be comforting for people of other faiths?

Listening to the Byzantine chants of Eastern Orthodoxy is powerful. The music is simultaneously mournful and hopeful, reflecting the pain of death but remembering that it is the start of a greater existence.

Angelo Volandes is a physician, writer, and patients’ rights advocate. He practices internal medicine at Massachusetts General Hospital in Boston, and is on faculty at Harvard Medical School. He is Co-Founder and President of Advance Care Planning (ACP) Decisions, a non-profit foundation implementing systems and technologies to improve the quality of care delivered to patients in the health care system. He is the author of the new book The Conversation: A Revolutionary Plan for End-of-Life Care, about how people can empower themselves to get the right medical care at the right time and on their terms.

Born and raised in Brooklyn, NY, he was educated at Harvard, Yale, and the University of Pennsylvania. He lectures widely across the country, and spends his time in Massachusetts with his wife Aretha Delight Davis, MD, JD and their two daughters.

When I hear news of a death, I feel as though I’m clicking into a higher gear. Life gets faster, details sharper. Everything extraneous falls away. On a practical level (in the world of assiyah) there are so many things which need to be decided: when will the funeral be held? How many nights of shiva does the family wish to observe? Is the obituary drafted, have family members been notified…?

On an emotional level (in the world ofyetzirah) there’s a heightened sense of awareness. It’s as though a sense-organ which usually lies dormant has been wakened. How do the family members seem to be feeling? What does this seem to be like for them, what do they need from me, how can I be there for them? And then there’s my own emotional landscape: what is this awakening in me? I file that away to be considered at a later time.

Intellectually (in the world of briyah) there’s the task of writing the hesped, the eulogy. The goal is to write something meaningful, something which gives a sense for the life which has now ended. The hesped needs to tell stories. It needs to feel real. And it needs to be utterly transparent: this isn’t about me as a writer, not about my oratory skills or turns of phrase. It’s about the life I’m trying to honor as best I can. My job is to get out of the way.

Spiritually (in the world of atzilut), all of those things intermingle. Death is a doorway into the unknown, a brush with Mystery. I think of it as returning to the Cosmic Source from which we came, like drops of water — having spent a lifetime falling in slow motion over the waterfall as individual droplets — rejoining the mighty rush of the river. But it’s one thing to say that, and another thing to really face the fact that a life has come to its end, that a soul has gone beyond where we can reach.

The physical world, the emotional world, the intellectual world, the spiritual world. These four worlds are hinted-at, say the kabbalists, in the four letters of God’s holiest Name. Those same letters can be mapped on to the human form. Each of us is an expression of that Name. Each of us contains worlds within us. When someone dies, their unique manifestation of those worlds returns to its Source. We are all reflections of that Name; in that sense we are all the same. And we’re also all different.

One of my favorite text from Talmud speaks about how God is greater than Caesar. Because when Caesar puts his image, his likeness, on every coin in the realm they all look identical. But when God puts God’s image, God’s likeness, on every human being we are all different. (Rabbi Arthur Waskow has written beautifully about this: God & Caesar – the Image on the Coin.) We are each a facet of God’s image; all alike, because we all contain a holy spark — and all different, because God is infinite.

When the body’s life has ended, the soul returns to the One from Whom it came. From the finitude of a single human body and a single human consciousness, to the infinity of our Source. I believe that there is no suffering on the “other side.” I believe that all of our human hurts and fears melt away as we rejoin Infinity. And I know that no matter what I believe about what happens after death, right now my faith isn’t as important as my obligation to try to tend to and care for those who grieve.

Her poetry books include 70 Faces: Torah poems, Waiting to Unfold, and Open My Lips, is forthcoming from Ben Yehuda Press. She is the author of several poetry chapbooks, among them What Stays (Bennington Writing Seminars Alumni Chapbook Series, 2002), Through (2009), a self-published collection of poems chronicling the experience of miscarriage and healing, and chaplainbook (laupe house press, 2006), a collection of poems arising out of hospital chaplaincy work.

Practicing mindfulness is something I have to do and remind myself of daily. But the real avenue that has allowed me to learn mindfulness and put it into practice, is being organized.

Being organized is my key to unlock mindfulness.

I think that when you are bogged down by chaos, by disorder, by little details that you just can’t seem to get a handle on, it’s easy to get overwhelmed. It’s easy to get frustrated. And those feelings get in the way of learning and practicing mindfulness.

For me, having a plan written down and having systems in place are essential. I have systems for my work, for meal planning, for kids’ therapy, for every small task that has to be done.

These little bits of organization liberate me.

They make it possible to focus on the moment at hand without worrying about dinner, or phone calls I need to make, or bills that need to get paid. Not worrying, just getting it done. Focusing on the moment.

I get overwhelmed too, but not by the small details. I have methods of filing papers and not having them piled everywhere. I can find what I need in my home and on my computer when I need it. I am rarely searching for small details, like a recipe, a file, an email, to get the big things done.

Get the big things done.

When you have those organizing tools in place, and the organized habits, you really can focus on the most important things. Your work, your family and your own happiness. Not that happiness comes easy. Bliss takes work. But I use organizing tools and habits to take the anxiety out of the little details. Tools to help me practice mindfulness. An organized life directly leads to a more mindful life, a more blissful life.

Adrienne Sweat grew up in Boston as the oldest of 8 kids. Her mother is an expert organizer and her father is a software developer and entrepreneur. She’s the mother of two kids with autism. She moved to Utah for college and stayed for a decade. While in Utah she served as a caregiver to her disabled mother-in-law. This has given her a wealth of experience in research, homeschooling, special meal plans, chore charts, and family schedules. Today she is a single mom living in Vancouver. You can learn more about her at Back to Bliss.

What does The Church of Religious Science teach happens to people when their lives end?

The physical part of life on earth ends, however our spirit/soul continues on its journey. Life cannot be destroyed; however the form it takes can change. We don’t talk about the ‘afterlife” because life continues after physical death. Whether we see it or not, it still exists. On the physical, worldly side, we also say that the spirit of a loved one lives on in the hearts and minds of those who were touched by that person — the impact of the person can be felt for generations to come.

How do you, as a Reverend, comfort the dying?

Compassion is the key. The most important gesture we can give is to honor the dying person by providing what is needed and required at the moment. With some, it is being a silent presence. For others (and with their request or approval), prayer is appropriate. Sometimes, readjusting the light blanket and smoothing it out is a loving gesture that would be appreciated. If the person wants to chat and reminisce, sip some refreshing water, or have privacy with family members, all is fine.

Since we believe that we are all One, we understand that, while it may be comforting to have the minister or practitioner present in the same room, the clergy does not have to be present for support to be felt. We say affirmative prayers, or spiritual mind treatments, for anyone at any time and under any circumstance. We believe that we are never separated from one another and therefore the impact of what we think, say, and do for one another can be felt at any time. It can even help transform the experience of the one who is dying – and help to bring calm, acceptance, or healing. Our clergy don’t claim magic or mystical powers for healing; we do feel that we all have the ability go back to the basics, for health, healing, peace and love. We also believe that each of us is on our own journey. We respect the wants and desires of the person who is dying. We do not give advice or judgment. We simply offer comfort in whatever way the person who is dying wants it. All is well.

How do members of your faith community traditionally respond to the death of one of their members?

We cry, we mourn, we share, we remember, and then we usually celebrate the life of the one who has passed on rather than stay stuck on somber feelings of regret and loss.

Is there a service to memorialize the dead?

Most services are called Celebrations of Life. There are pictures, favorite music, videos, and other memorabilia on display so that everyone attending can learn about the person. Oftentimes people from various phases of the person’s life are invited to share their remembrances. While sad, it is also a time when we can remember the most heartfelt parts of what that person brought to our lives. There is not much emphasis on a casket or cremation urn; rather it is about the spirit of the person that lives on.

What rituals of mourning are there in your faith?

There is no pre-determined ritual for Centers for Spiritual Living. We are a diverse and accepting community, therefore just about anything is acceptable. Although some choose to use candles or incense during the service these are not necessary – they may simply bring comfort to those in attendance. Sometimes there are informal gatherings or even parties held to honor the person who has died or spread the ashes. While we choose to look at the situation from a positive attitude of gratitude for the person, there is no shame in feeling sad or bad. The sweet and sour of life go together.

Is there a particular amount of time allocated for grieving?

There is no time limit to grieving; and neither is there an expectation that the loss of someone dear has to ruin the lives of those who remain. We believe that honest expression of feelings is better than repression. Grieving is unique and individual.

What text or passage would you suggest to a member of your faith community who is grieving?

Per Ernest Holmes in The Science of Mind textbook, “The Spirit is both birthless and deathless. The Principle of Life cannot know death. The experience of dying is but the laying off of an old garment, and the donning of a new one. “There are bodies celestial and bodies terrestrial; there is a material body and a spiritual body.” We are all of this.

What words would you share to comfort members of our community who may be mourning?

In our book,Heartfelt Memorial Services, there is a large section on “What to Say and What Not to Say” to someone who is grieving. Loss can be profound and it is always individual. We cannot presume to “know’ what the other person is going through. My main goal is to listen to the person grieving and to allow the time needed for that person to talk or cry or laugh. Oftentimes, taking the time to remember and talk about the loved one is the most soothing balm we can offer.

Is there a tradition from your faith that might be comforting for people of other faiths?

We have no vested interest in what people of other faiths believe about salvation or afterlife. Our own thoughts on these topics would take a back seat as we support others in going through their own rituals and feelings of loss.

Beverly Molander, MEd, RScM found close-knit, loving groups in church affiliations that began with Baptist churches in Eau Gallie and Tallahassee. After a sabbatical from any church during her twenties, Beverly found a close church community with the Unitarian Universalist community and, in the mid-eighties, she found a new spiritual home at the Atlanta Church of Religious Science (now Spiritual Living Center of Atlanta). In 1992, Beverly found herself to be a single mom rearing her son, Nigel, from the time he was two years-old. Beverly worked in radio or TV during the day and was with Nigel at night, and studied for her ministerial license in the time she had. Now an ordained minister, Beverly hosts a weekly radio show, Affirmative Prayer; Activating the Power of Yes, on Unity Online Radio.

As caregivers, we need ways to communicate honestly and effectively.

It seems a bit unfair to add one more required skill set on top of everything else we have to master, but if we’re attempting to take care of ourselves while taking care of another, we’ll likely find ourselves having many conversations that aren’t easy or simple. Whether these involve the person to whom we’re offering support and or people who are attempting to offer us support, it often helps if we can preface what we’re saying in a way that helps the person we’re talking to be better prepared to truly listen. Prefaces help both the speaker and listener drop into a place where they have the best likelihood of having a successful conversation.

Here are a few examples of some prefacing statements:

“There’s something I’ve really wanted to talk with you about. Would this morning be a good time? . . . ” “I wish I didn’t have to ask you this, but I really need your help . . . ” “Even though I’m doing okay overall, there are days when it feels like too much and I’m trying to figure out how I might reach out to others . . . ” “I know you’re in pain, but we really need to find a different way to do this . . . ” Ideally, prefacing statements are honest and clear, and demonstrate a respect for both ourselves and the person we’re speaking to. They also allow us to be at our best in moments when we’re at risk for not being at our best!

I’d invite you to think about how such prefacing statements might be helpful in sharing your needs and wants and wishes.

Also, think about the successful moments you’ve had when engaging in difficult conversations, and please share any tips. It’s always inspiring to learn from one another.

Karen Horneffer-Ginter, Ph.D. is the author of “Full Cup, Thirsty Spirit,” newly released from Hay House and available for purchase at bookstores, including Amazon.

I come from a family of fixers. My dad tells the story of seeing a broken lamp next to a broken vacuum on the curb. The obvious solution – to him – was to fix the lamp with the vacuum cord. And, 20 years later, when it broke again, I rewired it.

So, it comes as no surprise that we have a hard time with things that can’t be fixed. Acceptance is difficult when you view the world as a puzzle to be solved. While we’d like to figure out how to replicate stories of spontaneous cures, that’s not something we can realistically work toward.

For many people this is where religion kicks in. They’re responsible for a certain amount of effort, often tremendous effort, but ultimately the outcome is up to a higher power. Of course, Letting go to things outside of our control is easier said than done.

How do you let go and accept that some aspects of life are outside of your control?

1. Acknowledge that you don’t know what’s best

People aren’t very good at knowing what they want, so we’re certainly not very good at anticipating the best outcome. Sometimes getting what we hoped for doesn’t turn out so well in the end. By thinking of the possible positive outcomes in the outcomes you don’t want, they become less frightening.

Distraction and throwing yourself into caregiving is a great way to make it through taking care of what you need to do – it prevents us from getting lost in negative emotions while giving back some sense of control. But it’s equally important to make time and space to process what you’re going through. Meditation and journaling are great ways to do that.

3. Discover what really makes you happy

What gives your life a sense of purpose and meaning? Who brings you joy and a sense of belonging? What do you really need to be comfortable? Take the time to examine what’s really important in your life and focus your life to meet those goals. You don’t have to love your work or love your chores, but they’re a lot easier to do when you know they bring you closer to the people and things that bring you true joy.

The sooner we stop wasting time changing things that are outside of our control, the more energy we have to enjoy what we have right now.

Religion is an important source of strength for many of our members, so we’re asking clergy from different religious traditions to share how their members mark the end of a life. Chet Yoder served as pastor at the Bowmansville Mennonite Church for eighteen years before becoming the Director of Pastoral Services at Garden Spot Village in August, 2008. Garden Spot Village is a not-for-profit continuing care retirement community that is committed to Christian values and principles.

What does your faith teach about happens to people when their lives end?

As one who subscribes to the Christian faith, I believe that life continues following death. The spiritual connection we have with God is not discontinued by the death of the body. The Christian faith relies on the promises in the bible about the afterlife, which is often referred to as eternal life, life with its origin in the here and now, and which continues following the demise of the human body.

How do clergy comfort the dying? How do lay people comfort the dying?

Clergy often have specialized training in the care and comfort of the dying. We are taught to observe physical symptoms which suggest that death may be close. Often, we offer words of hope and encouragement from the perspective of faith. Sharing scripture readings, prayers, and music all are effective forms of ministry to the dying. And many times, simply being present is one of the most effective forms of ministry one can offer. Lay persons often offer ministry similar to clergy, depending upon the training they have received. We actively recruit lay persons to offer the ministry of presence to the dying when they have no one (family, etc.) attending to them when death is imminent.

How do members of the community traditionally respond to the death of one of their members?

The Garden Spot Village community often functions like a family when one of our members passes away. Residents offer prayers and words of sympathy and comfort if there is a surviving spouse, or to family members when they have opportunity. A notice of death, along with the time of the memorial service, is posted publicly so that neighbors and friends can offer their support and attend the service.

Is there a service to memorialize the dead? What is it like?

Very often a service is held following the death of one of our residents. This may be a funeral service several days after the death with the body present for viewing and visitation with the family. Many times a memorial service is held at the convenience of the family, sometimes weeks after the death event, which does not include a body for viewing but provides opportunity for visitation with the family and loved ones. The service will often include music (hymns, songs that were important to the deceased, etc.), a scripture reading and meditation, remembrances shared by family, friends, and neighbors. Often the service is followed by a time of refreshments and socializing in the lobby adjacent to the chapel. Occasionally when a resident dies who has been receiving nursing care in one of our nursing households, a brief time of remembrance will be held in the household. This service may include family, nursing staff, additional residents in the nursing household. On occasion we have used Skype to include family members in these memorial services who are able to attend the service.

What rituals of mourning are there in your faith?

I encourage persons to give expression to their grief. Sometimes, a spouse of son/daughter of the deceased will share a writing at the time of death or at the memorial service. Garden Spot Village chaplain staff provides for an end of life celebration ritual at the time of death. This bedside ritual includes scripture reading and prayers, along with placing a quilt over the deceased until the time of removal from our facility. The quilt is embroidered with a cross and butterflies, both powerful symbols of life and death in the Christian faith. I often have opportunity with families during the hours before the death of their loved one to encourage meaningful reflection of the life of their member, along with thoughtful reflection of the meaning of life (and death). At times my role includes encouragement to family and the dying person to “let go” and place themselves and their loved one into the hands of our loving God. I am a strong proponent of embracing “what is” and investing our energy into activity that is positive and proactive, rather than reactive.

Is there a particular amount of time allocated for grieving?

This varies greatly depending upon the family and attending circumstances of the death. Traditionally, memorial services were held several days following death, due primarily to the body being present for viewing and restrictions related to the necessity of burial within a proscribed amount of time. With the increasing popularity of cremation and decreasing practice of a traditional viewing, services may vary from several days following the death to weeks or even several months. Increasingly families are choosing a private internment of the remains with a public service held when family is able to convene.

The memorial garden at Garden Spot Village

What text or passage would you suggest to a member of your faith community who is grieving?

I have several passages which offer hope and encouragement. John 11 contains the account of Jesus’ grief at the death of his good friend Lazarus. Jesus, through his open display of grief, reveals to us that he also shares our grief and loss. Psalm 23 has been a universally loved passage which presents a pastoral view of the Good Shepherd who cares for his beloved in life and in death. I have also found Ecclesiastes 3:1-8 helpful in acknowledging the various passages of life, of which death is but one.

What words would you share to comfort members of our community who may be mourning?

I believe it is highly important to validate the unique grief experience of each person, as no two experiences are the same. I refrain from using sayings such as “I know how you are feeling” and “Don’t worry, God is in control”, believing that while we mean well with words like this, they tend to minimize the grief that persons are experiencing. I encourage persons to embrace their grief and assure them that God will hold them during this very difficult time. I often will remind persons that tears are a gift from God for occasions of grief and that we do well to use them. Many times, the gift of presence for those in grief speaks volumes more than words.

Is there a tradition from your faith that might be comforting for people of other faiths?

Perhaps the most helpful tradition I could highlight is one that is shared by persons of other faiths, that being the commitment of the community to share the grief experience. In our setting this occurs through personal visits, sending cards, an occasional food item, attending the visitation and service of the beloved, as well as remaining after the service for the food and fellowship which is in itself a wonderful support. We encourage participation in support groups as well and follow up with pastoral visits and specific information regarding the journey of grief.

A native of Mifflin County, PA, Chet Yoder has lived in Bowmansville for the past 25 years. Chet attended Rosedale Bible College in Irwin, OH, received his B.S degree from Lancaster Bible College in 1991, and a Master of Arts in Religion from Evangelical Seminary (Myerstown) in 2000. In addition he has completed 2 extended units of Clinical Pastoral Education and has done post-graduate work through the Center for Family Process in Potomac, MD. Ordained in the Lancaster Mennonite Conference, Chet served as pastor at the Bowmansville Mennonite Church for eighteen years prior to coming to Garden Spot Village in August, 2008, as Director of Pastoral Services. He is married to Sandy and father of three sons. In his spare time he enjoys reading, gardening, walking, and various sports activities with his sons.

Since we started the #100happydays challenge on our Instagram today, it got me thinking: how can I truly make an effort to be more positive everyday?

What I’ve discovered after only a few hours is that it is indeed a challenge, especially if some people in our lives aren’t quite ready to practice positivity. Or just aren’t accustomed to positive thoughts whatsoever.

Almost immediately after I decided to sign up for the challenge, I received not one, not two, but THREE text messages from three different friends saying something negative about their days yesterday. They ranged from, “my life is DRAMA” to “how was your day? I had THE WORST.”

Suddenly, I had a flashback to a few days earlier when I lent an ear to another friend going through a tough time (though, honestly, he seems to always be going through a tough time). Upon hanging up and letting out a *sigh* my partner said, be careful of how much you listen to your friends venting, Liz. That negative stuff can creep into your head even if you think it’s not. I thought about it for a second and, in true Taurean fashion, immediately dismissed him. I can handle it, I said, I’ve been friends with him for years. I know how he can get.

After this morning, though, I have to admit my partner was onto something. When the text messages came barreling in this morning – in paragraph form, no less – I realized I couldn’t keep up with all the various forms of mania and anxiety coming my way. There I was trying to maintain my inner peace and manage my own anxiety, when my eyes and ears became receptacles for unsolicited drama and anger. My heart beat picked up and immediately turned off my phone.

Call me a bad friend, perhaps, but what if not being there was exactly what I needed to do? Showing someone you care can come in so many different forms, tough love being one of them. If I was committed to my own happiness, I knew I’d have to cut off the craziness at some point, especially if it wasn’t my own.

At the end of the day, I am the only one I am obligated to cheer up, and sometimes that’s hard enough considering I suffer from bouts of depression. Maybe my friends would realize they aren’t the only ones going through something and consider they are the key to their own happiness, I thought. I will only be around for so long, but they’ll have to live with themselves forever!

I can only hope that my act of self-love and subsequent tough love will hold some emotional resonance. Only time will tell.

The subject of gratitude comes up frequently during conversations in my writer’s group for caregivers. Life has frayed us all around the edges, but we understand that each day is a gift, even if we want to exchange it now and then for something a little less ragged.

Occasionally, the topic comes up against the backdrop of the latest conflict here or abroad and other times it comes on the heels of a bad scare while caring for a loved one who is ill or aging. But after shaking our heads and finding terra firma once again, we release those frightening moments for just a little while, and instead talk about some of the things we are grateful for – having a mother who is still going strong at 90 and beyond; finally getting one good night’s sleep; still being able to laugh at the absurdities of life; or being able to carve two hours out of the month to share our writing with each other.

When I watch the this video by Brother David Steindal-Rast, I always come away with a deep sense of appreciation for all I have, especially the friendship of these amazing women who face their caregiving challenges with such grace and good humor.

Because of them, I’m reminded of the quote by Meister Eckhart, “If the only prayer you ever say is “thank you” that will be enough.

Religion is an important source of strength for many of our members, so we’re asking clergy from different religious traditions to share how their members mark the end of a life. Gadadhara Pandit Dasa is the first-ever Hindu chaplain of Columbia University and has spoken at a TEDx conference and has been featured on PBS, NPR, NY Times.

The Bhagavad Gita is considered as the most prominent Hindu texts and it’s the text I refer to when trying to provide solace to individuals who are grieving. It tells us that we are not the physical bodies. Rather, we are eternal spirit souls living within a body made up of matter. The following verses from chapter two of the Gita explain:

As a person puts on new garments, giving up old ones, the soul similarly accepts new material bodies, giving up the old and useless ones.

The soul can never be cut to pieces by any weapon, nor burned by fire, nor moistened by water, nor withered by the wind.

These verses alleviate our very basic and most fundamental concern, the fear of ceasing to exist. The Gita explains that the only thing about us that deteriorates and dies is the body, which is compared to an old set of garments.

The real person, the soul, continues to live on without being affected by any of the elements of this world, including the factor of time, which is ultimately responsible for diminishing the life of all matter. Time, however, has no effect on the spiritual self (soul).

This isn’t our first life and it’s not going to be our last. The soul is eternal and it will continue to exist even after the demise of the body. Knowing this can provide some solace about our own existence and the existence of those we care for.

Understanding that the real person never actually dies and continues to live on, I encourage people to continue to pray for the loved ones they have lost. I tell them that it’s never too late to pray because God will hear those prayers and assist their loved ones on their ongoing journey. This provides a lot of comfort for individuals who are grieving.

Different members of the community will respond differently to dying. The most natural thing is to mourn and remember all the joy and learning that person brought into our lives. Often times, people will take a picture of the deceased to the temple and offer some religious articles from the altar to that picture with the intention of benefitting the person wherever they may be. Generally, for a period of one year after the death of a relative, many Hindus won’t celebrate birthdays or anniversaries. This time period may vary within different families.

I encourage family members to remember the valuable life lessons that were learned from their family member and to try to follow through on those lessons. Thus, through their teachings and example, that person can continue to live in our heart.

Gadadhara Pandit Dasa is an author, meditation teacher, inspirational speaker, and lecturer at Columbia University and Union Theological Seminary. He has spoken at a TEDx conference and has been featured on PBS, NPR, New York Times, and writes for the Huffington Post. He has spoken at Google, Bank of America, Intel, Novartis, Harvard, Columbia, and many other institutions.

Pandit uses his life experience and decades of in-depth studies to assist people in overcoming the various stress factors in their own lives. The medical field now knows that stress leads to anxiety, insomnia, muscle tension, high blood pressure, and anger. Pandit’s unique approach applies Eastern wisdom and meditation techniques to help the audience gain deeper insight into their mind and understand the reasons we becomes stressed, anxious, and angry. A properly nourished mind becomes our best friend and helps us achieve better physical, emotional, and spiritual health. A healthy mind makes us more productive, allows us to improve our personal and professional relationships, and helps us maintain a positive perspective on difficult situations.

In the 2000 adventure film “Castaway,” Tom Hanks plays a character shipwrecked on a deserted island who is so desperate for companionship he endows a volleyball with human qualities and relates to it as if it were his best friend.

Wardens of prisoner-of-war camps and penal institutions have long recognized solitary confinement or complete isolation from fellow inmates as one of the most painful, dreaded forms of punishment. Human beings are social animals, and it comes as no surprise that isolation from family, friends, and other members of your “tribe” has a powerful effect on mental health. But in recent years, a number of studies have shown having (or not having) friends has a powerful influence on physical health, as well.

As it turns out, having friends is not only good for your soul but it’s good for your body, too.

People with Friends May Live Longer

A 2010 meta-analysis of 148 different research studies found that “people with stronger social relationships had a 50 percent increased likelihood of survival than those with weaker social relationships.”

The somewhat fuzzy term “social relationships” doesn’t have a universally accepted definition, but for researchers in the social sciences, it encompasses friends as well as family members. It also includes belonging to a church or volunteer organization.

To grasp the full impact of these findings, consider the comparative role of other known risk factors on survival: social relationships have about the same influence on the odds of dying earlier as smoking and alcohol consumption, and even more than physical inactivity and obesity.

So while losing weight and eating healthy top the list for most popular New Year’s resolutions, consider including “make new friends” on the list.

Why Social Relationships Prolong Life

The two main theories behind the influence of social relationships on longevity are thestress buffering model and the main effects model. Neither one is better than the other at explaining this influence; to varying degrees, they are both true.

Stress Buffering Model

According to this model, the people in our lives are a source of useful information as well as emotional, practical, and, sometimes, financial support. These resources promote healthier behavior, but more importantly, they influence our bodies’ physiological responses to acute or chronic stress. The benefits of our social relationships thus “buffer” the harmful influences of stress. Supportive friends help us weather the frustration, pain, loss, and disappointment that are an inevitable part of life.

Main Effects Model

According to this model, when people belong to a social network, they typically conform to its norms concerning health and self-care. Direct encouragement by friends or modeling of healthy behavior motivates us to take better care of ourselves. Being part of a social network also lends greater meaning and a sense of purpose to our lives and increases our self-esteem. Through direct encouragement and the example of their own behaviors, healthy friends show us how to take better care of ourselves. And when we do, it boosts our self-esteem.

The Cardiovascular and Immune Systems

In recent years, more detailed research has identified which specific disorders and conditions are influenced by strong social relationships. The list is long. Having good friends and other social connections has an impact on a wide range of conditions, from heart health to cancer.

A 2006 study found that strong social support has a positive impact on the cardiovascular and neuroendocrine systems, as well as the immune system and inflammatory processes implicated in poor health outcomes. Other studies have correlated a weak social network with depression, cognitive decline, poor wound healing, and delayed cancer recovery.

Another study explored the influence of “negative emotions” (anger, envy, despair, etc.) on the entire immune system. Inflammation has been linked to cardiovascular disease, osteoporosis, arthritis, type 2 diabetes, some forms of cancer, Alzheimer’s disease, and even periodontal disease. And because the inflammatory response “can be directly stimulated by negative emotions and stressful experiences,” the study authors argued that close personal relationships that diminish negative emotions may enhance health “through their positive impact on immune and endocrine regulation.”

These studies lend support to the stress buffering model: the emotional resources supplied by friends and other social connections ease the stress of life and lessen its effect on our physiological processes and, in particular, our immune system.

Not All Friends are Created Equal

We’ve all heard about or known kids who get involved with the wrong crowd and begin to act out or go downhill academically. Maybe you know of people who belong to a social set that exerts a bad influence: its members may be heavily involved with drugs, addicted to the party life, or overly status conscious, for example. While a supportive network of healthy friends can be uplifting, surrounding yourself with slackers or partiers may only add to life’s stressors.

Because our social connections influence our health habits, it’s crucial to form the right kind of bonds. At their best, strong marital ties, supportive family relationships, religious affiliation, and close friendships have been shown to reduce stress and promote healthy behaviors.12 On the flip side, a bad marriage or toxic friendship may instead generate negative emotions and increase a person’s stress levels. As a result, a person with unstable relationships may stop exercising, eat less healthy foods, drink more alcohol, or resort to recreational drugs.

According to the main effects model, when members of a social set engage in unhealthy or self-destructive behaviors, they encourage others to do the same. Good friends are good for your health, but bad ones have the opposite effect. Remember that the quality of your social relationships is more important than the quantity.

Hundreds of Friends but Not a Single Confidant

By now, it’s a cliché: day by day, the world’s population grows ever more interconnected. The internet is shrinking our planet and making it increasingly “flat” (in the words of Tom Friedman) so that tragedies befalling foreigners in distant countries no longer seem quite so remote. Hashtags that express unity with suffering citizens across the world spontaneously spring up and go viral.

On the domestic front, Americans routinely have hundreds of Facebook “friends” and Twitter followers. Every day, we tell each other about vacations and parties and social events. We exchange our viewpoints with tweets and instant messages. It would seem people today know more about each other than ever before. But do we really?

While we may have some connection with a greater number of people than before, our social relationships tend to be less intimate and more superficial. In part, we can attribute this development to a culture that sometimes reduces communication to 140-character comments and encourages people to proclaim their triumphs (but not their disappointments) to the whole world. Neither one is conducive to true intimacy.

A true friend or confidant is someone who cares about more than having a good time, who is willing to listen when you’re in pain, and shares his or her own struggles from time to time. A true friend knows who you truly are. When people add a “like” to something you posted to your Facebook news feed, that doesn’t mean they actually care about you.

There’s something to be said for casual acquaintances, be they at church, the workplace, school, or around the neighborhood. Some social relationships go deeper than others, and not every one of them needs to be truly intimate. But we all need a close friend or confidant who will listen when we want to talk about more than last night’s game or what happened on “American Idol.” Social relationships of all types and degrees of closeness are important, but having at least one confidant is crucial.

Make Good Friends by Being One Yourself

Human beings form social relations because we need them. We’re tribal by nature, developing our sense of self through interconnection. Only through our personal relationships – as life partners, friends, family members, and parents – can we fully self-actualize. Hardy social relations are crucial for our emotional and physical health.

As a guide for developing the kind of social connections we all need by virtue of our genetic inheritance, consider relying on a version of the old golden rule: relate to prospective friends as you would like them to relate to you in return.

First become the kind of friend you would like to find and treat potential candidates for friendship with the interest and respect you hope to receive. Then pay attention. If your consideration isn’t reciprocated, this social relationship could be one that only increases negative feelings and adds to stress. That’s bad for emotional well being, of course, but it’s bad for physical health as well.

Caregivers have a commitment in sustaining their own care while caring for a loved one. Caregiving can be challenging, and frequently requires extraordinary commitment, perseverance, and dedication, which will cause caregivers to ignore their own essential needs. Over time, as caregivers become engrossed in the care of their loved one, they cease to care for their own physical, mental, and spiritual well-being.

A fundamental approach caregivers can ensure caring of their own needs is through establishing and maintaining loving boundaries. Loving boundaries are firm, yet flexible boundaries. Loving boundaries compel caregivers and loved ones to have candid, honest, and open communication.

Caregivers who overlook their own physical, mental, and spiritual needs will ultimately burnout. Burnout can manifest as anger, frustration, and/or depression. Caregiver burnout can develop when boundaries have been not been clearly defined; as well as when open, honest, and direct communication with the loved one has not occurred.

Loving boundaries define emotional, behavioral, and physical sensitivities. Loving boundaries define the considerations for the Caregiver loved one relationship arrangement. Loving boundaries present acceptable emotional, behavioral, and physical expectations in their own and their loved one’s behavior. Unclear, inconsistent, or nonexistent boundaries become problematic for the Caregiver and loved one creating problems, as well as powerful negative emotional responses for both parties.

The possibility remains to change the situation through thoughtful reflection of the following:

Are you satisfied with the boundaries and routines you have established? For yourself? For your Loved One?

Determine your loved one’s authentic needs.

Are you meeting their needs?

Are you meeting your own needs?

How are you feeling

Are you often angry or frustrated?

Do you feel burned out?

If so, the CareGiving routine must change. CareGivers cannot continue when strong negative emotions are present. Examine the circumstances provoking strong emotions. These are areas in need of change, or stronger more consistent boundaries.

Determine a plan of action for establishing, re-establishing, or maintaining boundaries.

Have a candid, open conversation with your Loved One regarding the challenges, and how to resolve.

Important aspects for communication

Define the problem or challenge

Describe how you are feeling

Listen to your Loved One

Outline what you both need to resolve the situation

Your relationship is a partnership, both perspective are imperative

Give yourself permission to change the routine

Remember to care for yourself with regular personal time for you.

Ask yourself daily

How am I doing today?

What do I need to improve my well being?

Seek help if you are feeling overwhelmed, depressed, or cannot determine how to resolve the situation.

Religion is an important source of strength for many of our members, so we’re asking clergy from different religious traditions to share how their members mark the end of a life. Simran Jeet Singh, a doctoral candidate in the Department of Religion at Columbia University and regular contributor to The New York Times, TIME.com, and The Washington Post, was kind enough to speak about how the Sikh tradition approaches dying and mourning.

What does your faith teach about happens to people when their lives end?

The Sikh tradition (Sikhi) gives no clear explanation on what happens to people when their lives end. Sikhi does not place emphasis on afterlife, and instead, encourages people to focus on what can be achieved within our present lives. According to its religious teachings, this human life is a unique opportunity to connect with the Divine, to realize our potential, and to serve those around us.

How do religious leaders comfort the dying? How do lay people comfort the dying?

Sikhi believes that every individual has the same opportunity to develop a relationship with Divinity, and therefore there is no clergy in the Sikh tradition. Sikhs comfort the dying according to their wishes. Many Sikhs prefer to listen to religious music (kirtan) and recitation (path) during their final moments, and many also choose to spend final time with their loved ones.

How do members of the community traditionally respond to the death of one of their members?

Sikhi views death as a part of life and the Divine Order (hukam). According to Sikh traditions, death is not a time for mourning, but instead a time for gathering, remembering, and celebrating. Community members traditionally respond to the death of one of their members by organizing worship services in which people come together to praise the Divine and reflect on the life of the individual who passed away.

Is there a service to memorialize the dead? What is it like?

When a Sikh passes away, family and community members (sangat) gather together for worship. While the themes of the worship service may vary, people generally take this as an opportunity to express love and gratitude. Sikh worship primarily draws from the Sikh scripture (Guru Granth Sahib) — which is written in verse — and is typically conducted with collective singing and recitation.

What rituals of mourning are there in your faith? Is there a particular amount of time allocated for grieving?

The Sikh tradition teaches that life is to be lived with everlasting optimism (chardi kala). Therefore there is no ritual for mourning or grieving, even in a situation of a loved one’s passing.

What text or passage would you suggest to a member of your faith community who is grieving?

A scriptural composition traditionally sung at the time of one’s passing is Sohila. This composition, which is also a core part of Sikh liturgy, reflects on themes related to life, death, and celebration. The community has sung Sohila collectively since the formative moments of the Sikh tradition, and it continues to provide guidance and solace to those who reflect on its messages.

What words would you share to comfort members of our community who may be mourning?

Upon losing a loved one, it may be comforting to reflect on the transience of life and to remember that we are simply guests in this world. It may also help to reflect on concepts of humility, acceptance and graciousness. This ideas are exemplified throughout the Sikh scripture, including in this prayer from Guru Ramdas: “O Divine, you are the True Creator and my Divine Master. Whatever you please is what comes to pass, and whatever you give is what I receive.”

Is there a tradition from your faith that might be comforting for people of other faiths?

I find the Sikh tradition of framing death as an occasion for celebration to be incredibly comforting and powerful. This approach focuses on the positive contributions of one’s life and allows us to better preserve the memories and feelings of our loved ones. Celebrating rather than mourning also pushes us to count our blessings in a time of emotional vulnerability and helps us bring stability and solace into our lives, families, and communities.

Simran Jeet Singh is a Senior Religion Fellow at the Sikh Coalition. He is responsible for strengthening relationships among faith communities and supporting media outreach.

Simran is a doctoral candidate in the Department of Religion at Columbia University, focusing on devotional traditions and literatures of early modern South Asia. His expertise ranges from the formations of religious communities in early modern South Asia to xenophobia and hate violence in modern America. His dissertation research focuses specifically on the founder of the Sikh tradition – Guru Nanak– and the earliest available manuscript accounts of his life.

He earned an M.A. from the Department of Middle East and Asian Languages and Cultures of Columbia University (2009), an M.T.S. in South Asian Religious Traditions from Harvard University (2008), and a B.A. in English Literature and Religious Studies from Trinity University (2006). He is currently a Truman National Security Fellow and the Scott and Rachel F. McDermott Fellow for the American Institute of Indian Studies. In addition to his role with the Sikh Coalition, Simran serves in a voluntary capacity as the Director for the Surat Initiative and the board for the Sikh Spirit Foundation.

Simran speaks and writes on a wide range of issues relating to religion and culture. He contributes regularly to a number of media outlets, such as The New York Times, TIME.com, The Washington Post, and Newsweek’s The Daily Beast. He has also appeared on various television and radio programs, including BBC, NPR, CBS, and PBS. and in 2014 Simran delivered a keynote address at The White House.

I must not fear. Fear is the mind-killer. Fear is the little-death that brings total obliteration… ― Frank Herbert Dune

Fear an anxiety is widely common among caregivers. To understand fear and anxiety, we must first understand how the human mind works. The mind is the part of a human that thinks, reasons, feels and remembers, also known as the faculty of consciousness and thought, also known as the brain. According to studies in the psychology department of Pennsylvania State University, the average person speaks at a rate of 125 to 169 words per minute while thinking four times more rapidly. In other words, we think four times faster than we speak in a minute. An additional fun fact, Scientist discovered that it takes 13 milliseconds for the brain to see an image. In a nut shell, the brain/mind is super fast. How does this relate to fear and anxiety? Well, anxiety is defined as a feeling of worry, nervousness, or unease, typically about an imminent event or something with an uncertain outcome. The cause of anxiety is intrinsic in its definition. Anxiety is caused by the anticipation of something that’s yet to happen, and this begins in the mind. Thoughts causes feelings, and feelings leads to thoughts. A negative thought forms in our mind, and because of how fast the mind works, the thought takes root before we know it and the more we ponder on it, the more we feel unpleasant about it, leading to worry, unease, nervousness etc. Here’s an example of how this works. I have a headache, I begin to think about the headache, and a phrase like this forms in my head ¨this is bad,¨ the thought triggers a feeling of unease in me, which in turn triggers another thought, ¨what if it becomes worse?¨ this leads to a feeling of nervousness, followed by another thought, ¨what if it’s a migraine?¨ I begin to worry and the pattern continues until I become a train wreck of anxiety. Bear in mind that I may or may not have a migraine. Anxiety is like a little tear in a garment, unless patched up, it continues to get bigger and bigger. It all begins with a negative thought, the key is to nip it in the bud.

”We do not fear the unknown. We fear what we think we know about the unknown.”― Teal Swan

Whether we fear the unknown or we fear what we think, the point remains we fear. So how do we prevent ourselves from being unduly anxious? Having determined that anxiety begins in the mind, the way to also get rid of it begins in the mind, at its onset. It’s called attacking a problem at its root or nipping it in the bud. Our minds have the tendency toward negative thoughts, but we also control our minds. Therefore, we can control our thoughts. Here are three easy ways to get rid of anxiety.

Think positive and breath

Shift your focus on the environment

Do something like speaking to the space, standing instead of siting, walking around, jumping or bouncing, and touching object. Doing this may help you get out of your own head.

Write

Yes write about it. Writing about what’s making you anxious gives you a better perspective on it. It helps you identify your worry and gives you the ability to step away from it and look at it from afar. You might just discover there’s nothing to worry about.

During a drive to work I began thinking about the differences between an “average Joe” and a caregiver in terms of personality and temperament. Not to say we’re not “normal” (what is normal anyway?) or like every other human being, but I believe there is something that sets us apart.

1) Caregivers fill the gap systemically.

You make the phone calls. You take them to their appointments. You give the baths. You make the food. You do it all. So why is it so hard for others to see the need? Because you saw the bigger picture of what what needed, doesn’t mean others have or that they ever will. This was the hardest truth for me to manage as a caregiver. You see a need. A great need that isn’t easy, and choose to serve your loved one anyway. I cannot think of a more beautiful love. Through the resentment, betrayal from others, or envy you may feel, remind yourself that that this journey is a testament of your lovingkindness. You have a gift to be see what is needed in the various systems of your loved one’s life. You are not perfect, but you do what you can do fill the gap. Simply, those who would not see a need would not be able to help…definitely not in the ways that you do.

2) Caregivers have strong values.

You understand that there are standards we are to aim for in our lives, including a quality life. Your being in the midst of your loved one’s life proves that your aim is to help them thrive. Having a value system has a huge impact on how we make life decisions and prioritize our time. Again, because our values may differ from others, we can feel slighted quite often. We are looking through our own lenses and it seems so clear what we are striving for. This is what I love about caregivers– instead of choosing the path of least resistance (social norms or values), you choose to follow your moral compass (intrinsic values) instead…even if it means much more hardship.

I encourage you to take a small moment of your time and write out your top three values of life. Mine would look something like: 1) Communication and respect are key in any relationship 2) Family comes first 3) Show kindness to others even when it isn’t received. I would love to hear what yours are in the comments below.

3) Caregivers are leaders.

In order to be able to effectively caretake for someone, there are times we have to take hold of the reigns. We have to make the tough calls about our loved one’s health, safety, or security. Caregiving gives us additional purpose and call to action… a reason to advocate for more. Personally speaking, I never saw myself as a “leader” personality. I grew up painfully shy and am very meek-spirited. I believe caregiving showed me the reserves of strength and qualities I never knew I had deep down inside.

I hope you too are able to see how caregiving has grown and moved you. I hope you are able to see that you are a shining light in darkness. I hope you see that you are not set aside, but set apart from others. You are a caregiver.